MDMA-Assisted Psychotherapy

Untold thousands of practitioners have risked their licenses to use MDMA in underground clinical settings since 1985, when the drug was added to Schedule I (the Drug Enforcement Administration’s category for substances with no accepted medical use and a high potential for abuse).To these therapists, MDMA offers the opposite of party-hard escapism—instead, they see the drug as a catalyst for digging deep into the human psyche. For the four or so hours that a dose lasts, it prompts a surge in serotonin and dopamine (neurochemicals associated with sensations of happiness and pleasure) and oxytocin (the chemical messenger of trust and bonding that, for example, mothers feel when nursing their babies).MDMA also tames the brain’s fear center, the amygdala, and subdues the fight-or-flight response that pushes the nervous system into adrenaline-fueled overdrive in times of stress. Any apprehension a trauma patient might ordinarily suffer in therapy—about revisiting trigger memories or confronting painful emotions—is muted, but without the sedative effects of antianxiety medications.MDMA enhances the patient’s powers of visualization, but without the involuntary hallucinations conjured by psychedelic drugs such as LSD or psilocybin. And MDMA has profound (and as yet mostly mysterious) full-body analgesic properties. An injured veteran or victim of abuse can suddenly enter a world free of pain. A rape survivor or a person with an eating disorder can grasp what it’s like to be comfortable in her own skin.Supporters of legalized MDMA therapy believe it can be applied in couples counseling and in treatment for depression, body-image disorders, chronic pain management, and end-of-life anxiety. But many advocates think its best chance at mainstream acceptance is as a tool for people with PTSD.

“It shows you how to be kinder to yourself, and how much you’re capable of. It allows you access to a place in your mind that’s compassionate and full of love. You might have abandoned that place, but it never abandoned you.”